H. R. Kirchheim

Autoregulation of renal blood flow, glomerular filtration rate and renin release in conscious dogs

The relationship between renal artery pressure (RAP), renal blood flow (RBF), glomerular filtration rate (GFR) and the renal venous-arterial plasma renin activity difference (PRAD) was studied in 22 chronically instrumented, conscious foxhounds with a daily sodium intake of 6.6 mmol/kg. RAP was reduced in steps and maintained constant for 5 min using an inflatable renal artery cuff and a pressure control system.Between 160 and 81 mm Hg we observed a concomitant autoregulation of GFR and RBF with a high precision. The “break off points” for GRF- and RBF-autoregulation were sharp and were significantly different from each other (GFR: 80.5±3.5 mm Hg; RBF: 65.6±1.3 mm Hg;P<0.01). In the subautoregulatory range GFR and RBF decreased in a linerar fashion and ceased at 40 and 19 mm Hg, respectively.Between 160 mm Hg and 95 mm Hg (threshold pressure for renin release) PRAD remained unchanged; below threshold pressure PRAD increased steeply (average slope: 0.34 ng AI·ml−1·h−1· mm Hg−1) indicating that resting renin release may be doubled by a fall of RAP by only 3 mm Hg. At the “break-off point” of RBF-autoregulation (66 mm Hg) renin release was 10-fold higher than the resting level.It is concluded that under physiological conditions (normal sodium diet) GFR and RBF are perfectly autoregulated over a wide pressure range. Renin release remains suppressed until RAP falls below a well defined threshold pressure slightly below the animals resting systemic pressure. RBF is maintained at significantly lower pressures than GFR, indicating that autoregulation of RBF also involves postglomerular vessels. Our data are in agreement with the myogenic hypothesis as a basic mechanism of autoregulation.

Autoregulation of renal blood flow in the conscious dog and the contribution of the tubuloglomerular feedback.

1 The aim of this study was to investigate the autoregulation of renal blood flow under physiological conditions, when challenged by the normal pressure fluctuations, and the contribution of the tubuloglomerular feedback (TGF). 2 The transfer function between 0.0018 and 0.5 Hz was calculated from the spontaneous fluctuations in renal arterial blood pressure (RABP) and renal blood flow (RBF) in conscious resting dogs. The response of RBF to stepwise artificially induced reductions in RABP was also studied (stepwise autoregulation). 3 Under control conditions (n= 12 dogs), the gain of the transfer function started to decrease, indicating improving autoregulation, below 0.06‐0.15 Hz (t= 7‐17 s). At 0.027 Hz a prominent peak of high gain was found. Below 0.01 Hz (t> 100 s), the gain reached a minimum (maximal autoregulation) of ‐6.3 ± 0.6 dB. The stepwise autoregulation (n= 4) was much stronger (‐19.5 dB). The time delay of the transfer function was remarkably constant from 0.03 to 0.08 Hz (high frequency (HF) range) at 1.7 s and from 0.0034 to 0.01 Hz (low frequency (LF) range) at 14.3 s, respectively. 4 Nifedipine, infused into the renal artery, abolished the stepwise autoregulation (‐2.0 ± 1.1 dB, n= 3). The gain of the transfer function (n= 4) remained high down to 0.0034 Hz; in the LF range it was higher than in the control (0.3 ± 1.0 dB, P< 0.05). The time delay in the HF range was reduced to 0.5 s (P < 0.05). 5 After ganglionic blockade (n= 7) no major changes in the transfer function were observed. 6 Under furosemide (frusemide) (40 mg + 10 mg h−1 or 300 mg + 300 mg h−1 i.v.) the stepwise autoregulation was impaired to ‐7.8 ± 0.3 or ‐6.7 ± 1.9 dB, respectively (n= 4). In the transfer function (n= 7 or n= 4) the peak at 0.027 Hz was abolished. The delay in the LF range was reduced to ‐1.1 or ‐1.6 s, respectively. The transfer gain in the LF range (‐5.5 ± 1.2 or ‐3.8 ± 0.8 dB, respectively) did not differ from the control but was smaller than that under nifedipine (P < 0.05). 7 It is concluded that the ample capacity for regulation of RBF is only partially employed under physiological conditions. The abolition by nifedipine and the negligible effect of ganglionic blockade show that above 0.0034 Hz it is almost exclusively due to autoregulation by the kidney itself. TGF contributes to the maximum autoregulatory capacity, but it is not required for the level of autoregulation expended under physiological conditions. Around 0.027 Hz, TGF even reduces the degree of autoregulation.

Threshold pressure for the pressure-dependent renin release in the autoregulating kidney of conscious dogs.

Abstract1.The effect of varying renal artery pressure between 160 and 40 mm Hg on renal blood flow and renin release was studied in seven conscious foxhounds under β-adrenergic blockade receiving a normal sodium diet (4.1 mmol/kg/day). Pressure was either increased by bilateral common carotid occlusion or reduced in steps and maintained constant by a control-system using an inflatable renal artery cuff. Carotid occlusion itself had no influence on renal blood flow and renin release when renal artery pressure was kept constant and the β-receptors in the kidney were blocked.2.Between 160 mm Hg and resting pressure there was no change in renal blood flow; between resting blood pressure and the lower limit of autoregulation (average 63.9 mm Hg) renal blood flow increased slightly (average 7%) indicating a high efficiency of renal blood flow autoregulation.3.The relationship between renal artery pressure and renin release could be approximated by two linear sections:a low sensitivity to a pressure change (average slope: −0.69 ±0.26ng AI/min/mm Hg) was found above a threshold pressure (average: 89.8±3.3 mm Hg) and a high sensitivity to a pressure change (average slope: −64.4±20.8 ng AI/ min/mm Hg) was observed between threshold pressure and 60 mm Hg. There was no further increase of renin release between 60 and 40 mm Hg.4.It is concluded that within the autoregulatory plateau the kidney of a conscious β-blocked dog receiving a normal sodium diet releases only negligible amounts of renin until renal artery pressure falls below a threshold pressure of 90 mm Hg which is close to the animals resting systemic pressure. Since beyond that a decrease of systemic pressure by as little as 1.3 mm Hg below threshold can raise resting renin release (84.8±29.8 ng/min) by 100%, it is suggested that systemic blood pressure tends to stabilize at a level at which renin release is minimal.

Sympathetic modulation of renal hemodynamics, renin release and sodium excretion

SummaryIn anesthetized animals it has been shown previously, that the influence of electrical stimulation of efferent renal nerves on renal function with increasing stimulation frequencies can be graded; renin release is affected at low, sodium excretion at intermediate and vascular resistance at high stimulation frequencies.Experiments in conscious dogs are reviewed, which present evidence for a similar functional dissociation under physiological conditions.Moderate activations of the renal sympathetic nerves, which do not change renal blood flow 1) decrease sodium excretion independent of changes in angiotensin II, 2) interact with the pressure-dependent mechanism of renin release by resetting its threshold pressure and 3) modulate autoregulation by increasing the lower limits of glomerular filtration rate and renal blood flow-autoregulation.These findings may contribute to our understanding of the role of the renal nerves in the pathophysiology of congestive heart failure and hypertension.

Baroreflex sympathetic activation increases threshold pressure for the pressure-dependent renin release in conscious dogs.

Stimulus-response curves relating renal-venous-arterial plasma renin activity difference (P.R.A.-difference) to mean renal artery pressure (R.A.P.) were studied in seven chronically instrumented conscious foxhounds with a daily sodium intake of 6.1 mmol/kg. R.A.P. was reduced in steps and maintained constant for 5 min using an inflatable renal artery cuff and a pressure control system.The stimulus-response curve obtained during control conditions (C) or during common carotid artery occlusion (C.C.O.) could be approximated by two linear sections: a rather flat section or plateau-level of P.R.A.-difference at normal blood pressure or above, and a very steep section between a distinct threshold pressure and 65–70 mm Hg. While the parameters of the curves varied from dog to dog, the curves kept their inique shape in the individual dog for at least 1 week. C.C.O. had no effect on the plateau-level of the P.R.A.-difference (C:0.98±0.14,C.C.O.:0.99±0.14 ng Al·ml−1·h−1) and on the slope of the curve below threshold pressure (C:−0.379±0.041,C.C.O: −0.416±0.082 ng Al·ml−1·h−1·mm Hg−1) but shifted the stimulus-response curve to the right and increased threshold pressure (C:92.7±2.8,C.C.O.:109.7±4.1 mm Hg;P<0.05).Renal blood flow, which was measured simultaneously in three of the dogs, showed good autoregulation down to 70 mm Hg under resting conditions and was not affected by C.C.O. except for a 30% reduction of renal blood flow at the lowest pressure step (70 mm Hg).β-Adrenergic blockade in 4 of the dogs reduced the plateau-level of the P.R.A.-difference from 0.86±0.19 to 0.36±0.05 ng AI·ml−1·h−1 (P<0.05) but had no effect on the increase of threshold pressure elicited by C.C.O.It is concluded that the stimulus-response curve for the pressure-dependent renin release has a remarkable long-term stability in the individual dog. The curve is shifted to the right by a moderate carotid baroreflex increase of renal sympathetic nerve discharge which leaves total renal blood flow largely unchanged. It is suggested that the increase in threshold pressure is independent of β-adrenergic effects.

Effect of sino-aortic denervation in comparison to cardiopulmonary deafferentiation on long-term blood pressure in conscious dogs.

The isolated and combined influence of cardiopulmonary and sinoaortic denervation on long-term blood pressure (MAP), heart rate (HR), plasma renin activity (PRA) and plasmavolume (PV) was studied in 11 conscious, chronically instrumented foxhounds receiving a normal sodium diet. MAP, HR, PV and PRA remained unchanged in the 5 dogs after bilateral thoracic vagal stripping, which eliminates the cardiopulmonary afferents. After sino-aortic denervation in another 5 dogs there was equally little change when compared to the control group. Only total baroreceptor and cardiopulmonary denervation (7 dogs) revealed significantly higher levels of MAP (119.6±4.6 vs. 100.4±1.5,P<0.01), HR (118.2±3.7; vs. 84.1±3.5;P<0.0001), and PRA (3.6±0.9 vs. 0.9±0.2;P<0.05). In conclusion, the function of either arterial baroreceptors or cardiopulmonary receptors is sufficient for normal circulatory control. When both groups of receptor afferents are interrupted, MAP, HR, and PRA rise to significantly higher levels. Thus, both systems interact in a sense of a nonadditive attenuation on “cardiovascular centres”. This may clarify previous disputes concerning neurogenic hypertension, and supplies information for the role of the renin-angiotensin system in blood pressure control.

Effects of bilateral carotid occlusion and auditory stimulation on renal blood flow and sympathetic nerve activity in the conscious dog

In conscious foxhounds with intact aortic baroreceptors the effects of common carotid occlusion (C. C. O.; 3 dogs) or excitement (elicited by a sudden loud noise due to firing a pistol; 7 dogs) on renal blood flow (R.B.F.) were studied. C.C.O. increased arterial blood pressure by 40–50 mm Hg and heart rate by 22 beats/min while R.B.F. remained unchanged. When kidney perfusion pressure was maintained during C.C.O. there was also no change in R.B.F. Excitement increased mean aortic blood pressure by 35 mm Hg and heart rate by 84 beats/min; R.B.F. was transiently reduced by 40% of control.In another 3 foxhounds successful recordings of renal sympathetic nerve activity (R.S.N.A.) were obtained in the conscious state for 2–7 postoperative days. The effects of C.C.O. or excitement — elicited by whistling or hand-clapping — on R.S.N.A. were tested. There was pulse-synchronous nerve activity in the resting conscious animal. C.C.O. induced a steady state increase of averaged R.S.N.A. by 62% of control. Excitement was associated with transient bursts of activation of averaged R.S.N.A. by 500% of control.It is concluded that total R.B.F. is not changed during the baroreceptor short-term adjustment of blood pressure although changes in sympathetic outflow to the kidney are observed under comparable conditions. In contrast, excitement causes a much higher degree of sympathetic activation; this is probably responsible for the intense, transient renal vasoconstriction.

Interaction between perfusion pressure and sympathetic nerves in renin release by carotid baroreflex in conscious dogs.

1. The effect of bilateral carotid occlusion on carotid sinus pressure, systemic blood pressure, heart rate, renal blood flow, renal‐venous and arterial plasma renin activity was studied in twelve trained conscious foxhounds on a normal sodium diet (4.7 mmol/kg per day). 2. When renal perfusion pressure was allowed to rise with systemic pressure by 51.0 +/‐ 6.3 mmHg during carotid occlusion, renin release decreased by 72.3 +/‐ 22.2 ng/min (78% of control; P less than 0.05) while renal blood flow remained at its resting level of 232.7 +/‐ 20.1 ml/min (n = 8 dogs). 3. When renal perfusion pressure was maintained constant at 93.0 +/‐ 3.6 mmHg during carotid occlusion (suprarenal aortic cuff), renin release increased by 154.6 +/‐ 60.4 ng/min (73% of control; P less than 0.05), again there was no significant change of renal blood flow (n = 7 dogs). 4. After beta‐adrenergic blockade carotid occlusion increased systemic blood pressure by 47.7 +/‐ 7.8 mmHg, decreased renin release by 34.6 +/‐ 9.9 ng/min (67% of control; P less than 0.05) and had no effect on renal blood flow (n = 4 dogs). 5. When renal perfusion pressure was controlled at its resting level, no significant change of renin release and renal blood flow was observed during carotid occlusion in the surgically denervated kidney (n = 3 dogs) or in the intact kidney after beta‐adrenergic blockade (n = 4 dogs). 6. It is concluded that a reduction of carotid sinus pressure in the conscious dog increases renin release by a direct beta‐adrenergic stimulation without exerting vasomotor effects provided renal perfusion pressure is maintained at control level. The vascular receptor mechanism can effectively counteract the stimulating influence of the renal sympathetic nerves when perfusion pressure is allowed to rise.

Role of angiotensin II in dynamic renal blood flow autoregulation of the conscious dog

The influence of angiotensin II (ANGII) on the dynamic characteristics of renal blood flow (RBF) was studied in conscious dogs by testing the response to a step increase in renal artery pressure (RAP) after a 60 s period of pressure reduction (to 50 mmHg) and by calculating the transfer function between physiological fluctuations in RAP and RBF. During the RAP reduction, renal vascular resistance (RVR) decreased and upon rapid restoration of RAP, RVR returned to baseline with a characteristic time course: within the first 10 s, RVR rose rapidly by 40 % of the initial change (first response, myogenic response). A second rise began after 20–30 s and reached baseline after an overshoot at 40 s (second response, tubuloglomerular feedback (TGF)). Between both responses, RVR rose very slowly (plateau). The transfer function had a low gain below 0.01 Hz (high autoregulatory efficiency) and two corner frequencies at 0.026 Hz (TGF) and at 0.12 Hz (myogenic response). Inhibition of angiotensin converting enzyme (ACE) lowered baseline RVR, but not the minimum RVR at the end of the RAP reduction (autoregulation‐independent RVR). Both the first and second response were reduced, but the normalised level of the plateau (balance between myogenic response, TGF and possible slower mechanisms) and the transfer gain below 0.01 Hz were not affected. Infusion of ANGII after ramipril raised baseline RVR above the control condition. The first and second response and the transfer gain at both corner frequencies were slightly augmented, but the normalised level of the plateau was not affected. It is concluded that alterations of plasma ANGII within a physiological range do not modulate the relative contribution of the myogenic response to the overall short‐term autoregulation of RBF. Consequently, it appears that ANGII augments not only TGF, but also the myogenic response.

Tonic and phasic influences of nitric oxide on renal blood flow autoregulation in conscious dogs

The aim of this study was to investigate the influence of the mean level and phasic modulation of NO on the dynamic autoregulation of renal blood flow (RBF). Transfer functions were calculated from spontaneous fluctuations of RBF and arterial pressure (AP) in conscious resting dogs for 2 h under control conditions, after NO synthase (NOS) inhibition [ N G-nitro-l-arginine methyl ester hydrochloride (l-NAME)] and afterl-NAME followed by a continuous infusion of an NO donor [ S-nitroso- N-acetyl-dl-penicillamine (SNAP)]. After l-NAME ( n = 7) AP was elevated, heart rate (HR) and RBF were reduced. The gain of the transfer function above 0.08 Hz was increased, compatible with enhanced resonance of the myogenic response. A peak of high gain around 0.03 Hz, reflecting oscillations of the tubuloglomerular feedback (TGF), was not affected. The gain below 0.01 Hz, was elevated, but still less than 0 dB, indicating diminished but not abolished autoregulation. Afterl-NAME and SNAP ( n = 5), mean AP and RBF were not changed, but HR was slightly elevated. The gain above 0.08 Hz and the peak of high gain at 0.03 Hz were not affected. The gain below 0.01 Hz was elevated, but smaller than 0 dB. It is concluded that NO may help to prevent resonance of the myogenic response depending on the mean level of NO. The feedback oscillations of the TGF are not affected by NO. NO contributes to the autoregulation below 0.01 Hz due to phasic modulation independent of its mean level.